EKSTREMİTE YUMUŞAK DOKU SARKOMLARINDA CERRAHİ KALİTENİN DEĞERLENDİRİLMESİ

İlker Dedeli, Bedii Şafak Güngör, AHMET FEVZİ KEKEÇ , HALİL SEZGİN SEMİZ, Şefik Murat Arıkan, Yaman Karakoç

  • Bedii Şafak Güngör: Ankara Onkoloji Eğitim ve Araştırma Hastanesi Tıp Fakültesi
  • AHMET FEVZİ KEKEÇ: NECMETTİN ERBAKAN ÜNİVERSİTESİ
  • HALİL SEZGİN SEMİZ: SAĞLIK BAKANLIĞI
  • Year : 2026
  • Vol : 42
  • Issue : 1
  •  Page : 8-14
Amaç: Extremite yumuşak doku sarkomlarının esas tedavisi geniş cerrahi eksizyon ve buna kombine edilen radyoterapi ve/veya kemoterapidir. Ekstremite yumuşak
doku sarkomları negatif sınırlı cerrahi rezeksiyon ve adjuvan radyoterapiye rağmen lokal tekrarlama eğilimindedir. Çalışmada cerrahi kalitesinin değerlendirilmesi
amacıyla yakın ve uzak dönem lokal nüks oranları belirlendi. Bu çalışmanın amacı, tümörün lokal kontrolünde etkili olan prognostik faktörler dikkate alınarak cerrahi
kalitenin değerlendirilmesidir.
Gereç ve Yöntemler: Ekstremite yerleşimli yumuşak doku sarkomu tanısıyla tedavi edilen 130 hasta retrospektif olarak incelendi. Lokal nükse etki eden cerahi sınır,
sarkom boyutu, derinlik, histotip, grad ve adjuvan / neoadjuvan tedavi protokolü, plansız cerrahi gibi parametreler değerlendirilmeye alındı.
Bulgular: Hastaların ortalama takip süresi 44 ay(20-70) idi. Extremite koruyucu cerrahi uygulanan 118 hastanın 96’sına R0 rezeksiyon, 32’ sine R1 rezeksiyon yapıldı.
20 aylık takiplerinde lokal nüks oranları; cerrahi sınır negatif olanlarda % 19, cerrahi sınır pozitif olanlarda ise % 28’dir. 3 yıllık takiplerimizdeki lokal nüks oranları;
R0 sadece cerrahi tedavi uygulananlarda % 24, R0 olanlarda cerrahi+RT uygulananlarda % 21 iken, R1 olanlarda re-rezeksiyon sonrası % 34, R1 olup sadece RT
uygulananlarda % 38 olarak bulundu.
Sonuç: Cerrahi sınır kalitesinin en önemli belirteci lokal rekürrenssiz süredir. Extremite yumuşak doku sarkomlarının tedavisi optimal cerrahi kaliteyi sağlayabilmek
için sarkom vakaları multidisipliner tümör kurullarında tartışılmalı ve tedaviler hastanın klinik ve demografik özelliklerine ve sarkomun histopatolojik tipine göre
bireyselleştirilmelidir. Yumuşak doku sarkomlarının cerrahi tedavisi fizyopatolojisine hakim özelleşmiş bir ekip tarafından yapılmalıdır. Erken tanı ve tedavinin
sağlanabilmesi ve plansız cerrahinin önüne geçilmesi için birinci basamak hekimler ve hastalar için eğitimler planlanılmalı ve sarkom merkezine doğrudan sevk
sağlanmalıdır.
Cite this Article As : Dedeli I, Gungor BS, Kekec AF, Semiz HS, Arikan SM, Karakoc Y. Evalutaion of Surgical Quality in Extremity Soft Tissue Sarcomas. Selcuk Med J 2026;42(1): 8-14

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Conflict of interest : The authors declare that they have no conflict of interest.
This article is published under the CC BY-NC 4.0 license.
Selcuk Medical Journal
2026, Vol. 42 (1)
ISSN: 1017-6616
E-ISSN: 2149-8059
Received : , Accepted : , Published Online :

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